Organization
AGING AND DIVERSE HOME HEALTHCARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA WILLIAMS RN (ADMINISTRATOR)
(215) 991-6222
Entity
Organization
Contact information
Practice address
5537 GERMANTOWN AVE FL 1, PHILADELPHIA, PA 19144-2225
(215) 991-6222
Mailing address
5537 GERMANTOWN AVE FL 1, PHILADELPHIA, PA 19144-2225
(215) 991-6222
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
RN527652L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0019540140002
MA ID
PA
05
—
0019540140003
—
PA
Enumeration date
01/28/2009
Last updated
05/10/2021
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